Hospitals Charge More, Because They Can!

In this age of information, we thought it was about time for an informal conversation with our patients, referring physicians and anyone else who is interested. MNAP has always been on the cutting edge of technology and social media was the best logical choice to get some thoughts out and address some questions and concerns.

We hope this will be the first installment of many and expect that the topics will come from anywhere starting with inspiration from articles in professional publications and ending with issues that come up in everyday patient care.

My first topic came to me from an article in the Radiology Business Journal that discussed the lack of regulation in the rates that facilities charge for medical procedures in general and radiology in particular. As it turns out, outside of the state of Maryland, there is no price regulation at all and the same procedure that costs $300 at one facility can cost $3000 at another (no exaggeration!). Not only that, but apparently hospitals charge a lot more for “technical components”. And with insurance coverage (or lack thereof) being what it is today, guess who gets stuck with the bill?

In addition, insurance companies make allowances for hospitals that they do not make for freestanding facilities, permitting them to charge for such “technical components” and “radiologist fees” (Yeah, this is where my eyes popped out of their sockets. If the radiologist reading is an inseparable part of getting a radiological procedure why am I getting charged twice?!). So what? They allow it, so they cover it, right? Wrong! Most insurances have a coinsurance, a percentage that a patient pays out-of-pocket. So if you go to a hospital, instead of a private facility, your out-of pocket payment is likely to be exponentially larger.

I found this out for myself just recently when I had to get a chest x-ray as an outpatient at a hospital and got a bill for over $200 that was not covered by insurance. (If I knew this in advance I would have just kept on coughing) The same chest x-ray that would have cost me $85 if I had paid for the whole thing myself at MNAP Radiology. So the obvious question arises: Why are hospitals charging so much more? Well, honestly, because they can get away with it.